• Next Generation EU - Mecanismo para la Recuperación y la Resiliencia (MRR), CSL Vifor, Astellas España, Sociedad Española de Trasplante

• Clinical practice guidelines
• Heart failure
• Kidney transplantation
• Preoperative evaluation
• Pulmonary hypertension

• Predictors
• chronic kidney disease
• meta-analysis
• prevalence
• prognostic
• pulmonary hypertension

• Humans
• Hypertension, Pulmonary/epidemiology
• Hypertension, Pulmonary/etiology
• Renal Insufficiency, Chronic/complications
• Renal Insufficiency, Chronic/epidemiology
• Prevalence
• Prognosis
• Risk Factors
• Renal Dialysis
• Observational Studies as Topic

• Cardiovascular
• Chronic kidney disease
• Energy loss
• Prognosis
• Strain

• Humans
• Male
• Female
• Middle Aged
• Renal Insufficiency, Chronic/physiopathology
• Renal Insufficiency, Chronic/complications
• Renal Insufficiency, Chronic/mortality
• Renal Insufficiency, Chronic/diagnosis
• Stroke Volume/physiology
• Aged
• Prospective Studies
• Predictive Value of Tests
• Ventricular Function, Left/physiology
• Echocardiography/methods
• Follow-Up Studies
• Cohort Studies
• Prognosis

• Chronic kidney disease
• End-stage renal disease
• Kidney transplantation
• Management
• Outcome
• Pulmonary hypertension

• right ventricular outflow tract
• ventricular arrhythmia

• MOST110-2314-B-038-107-MY3, MOST110-2314-B-016-037-MY3, MOST 111-2314-B-016-006-MY3, and MOST111-2314-B-281-003-MY3 Ministry of Science and Technology Taiwan
• MND-MAB-D-112098 Ministry of National Defense-Medical Affairs Bureau Taiwan
• CGH-MR-A11109 Cathay General Hospital, Taiwan

Given the high cardiovascular risk accompanying end-stage kidney disease, it would be of paramount importance for the clinical nephrologist to know which screening method(s) identify high-risk patients and whether screening asymptomatic transplant candidates effectively reduces cardiovascular risk in the perioperative setting as well as in the longer term. Within this review, key studies concerning the above questions are reported and critically analyzed. The lack of unified screening criteria and of a prognostically sufficient screening cardiovascular effect for renal transplant candidates sets the foundation for a personalized patient approach in the near future and highlights the need for well-designed studies to produce robust evidence which will address the above questions.

• conventional echocardiography
• end stage renal disease
• heart failure
• hemodialysis
• peritoneal dialysis
• right ventricular function

• Cardiovascular Diseases/diagnosis
• Cardiovascular Diseases/epidemiology
• Cardiovascular Diseases/etiology
• Cohort Studies
• Heart Failure/etiology
• Humans
• Kidney Transplantation/adverse effects
• Risk Factors
• Transplant Recipients

Right ventricular (RV) function is an important prognostic predictor for end-stage renal disease (ESRD) patients. Non-invasive evaluation of RV function by simple electrocardiogram (ECG) is not yet evident. The purpose of this article was to investigate the presence and association of pathological right ventricular changes in synthesized ECG with cardiac hospitalization and mortality.

A prospective cohort study of 137 ESRD patients (mean age: 56 years) were recruited from the hemodialysis unit in An-Najah National University Hospital, Nablus, Palestine. Synthesized ECG was done right before the hemodialysis (HD) session. The pathological right ventricular changes were recorded for each patient. The relationship between pathological RV changes and mortality, cardiac and non-cardiac hospitalization was assessed through a 6-months follow-up period.

Right ventricular Q wave was found in 2.2% of patients, while right ventricular ST elevation was found in 0.7% of patients, and right ventricular negative T wave was found in 0.7% of patients. During the 6-month period of follow-up, 36 (26.3%) patients were hospitalized, nine patients (6.6%) due to cardiac causes. A total of 8 (5.83%) patients died, out of those 4 patients (2.91%) due to cardiac causes. Using Fisher’s exact test, there was a significant association between pathological abnormalities in synthesized ECG and hospitalization among hemodialysis patients, (p = 0.047). Pathological changes in synthesized ECG were less prevalent in non-cardiac hospitalizations than in cardiac hospitalizations.

The presence of pathological RV synthesized ECG changes can predict cardiac hospitalization in ESRD patients. Synthesized ECG is a good available tool that can be easily performed in ESRD patients. To determine whether Synthesized ECG can be used as a screening tool for pathological RV changes in a dialysis patients, more research with a larger number of patients and a longer follow-up period is required.

• Cardiac hospitalization
• Mortality
• Right ventricle
• Synthesized ECG
• Ultra filtration
• Volume load

The post 3 kidney transplant course of pretransplant echocardiographically‐defined pulmonary hypertension (PH) was reviewed in 115 patients. Of these 61 patients (the largest cohort reported to date), underwent 160 “for indication” echocardiograms posttransplant (mean echocardiograms per patient: 2.6 ± 2.3). Patients undergoing posttransplant echocardiograms demonstrated greater risks for worse outcomes than those without posttransplant echocardiograms; however, there was no difference in mortality, death‐censored graft failure or the composite of death or graft failure between these two groups. Of patients tested, 36 (59%) showed resolution of PH at a median of 37.5 months. Six patients (16.7%) in whom PH resolved (at a median of 29 months), experienced recurrence of PH after an interval of 48 months. No pretransplant demographic or echocardiographic characteristics distinguished those in whom PH persisted versus resolved. Though there was no difference in the risk for mortality or death‐censored graft loss between the two groups at 3 and 5 years, there was a higher risk for the composite of mortality or graft loss at three but not at five years in the group with persistent PH. In conclusion, echocardiographically defined PH resolved in 59% of patients following kidney transplantation; but irrespective of resolution there was no clear association with worse outcome.

• K01 DK101677 NIDDK NIH HHS
• K23 DK115908 NIDDK NIH HHS
• K24 DK101828 NIDDK NIH HHS

• End-stage renal disease
• Renal transplant
• Right ventricular dilation
• Right ventricular dysfunction

• Clinical Decision-Making
• Consensus
• Decision Support Techniques
• Humans
• Kidney Failure, Chronic/diagnosis
• Kidney Failure, Chronic/surgery
• Kidney Transplantation/adverse effects
• Kidney Transplantation/standards
• Patient Selection
• Predictive Value of Tests
• Risk Assessment
• Risk Factors

• Arterio-venous fistula
• chronic kidney disease
• hemodialysis
• pulmonary hypertension

• PAH
• Pulmonary hypertension
• acute kidney injury
• chronic kidney disease
• pathophysiology
• transplantation.

Introduction: Systemic lupus erythematosus (SLE) myocarditis occurs in between 5% and 10% of patients with lupus. Global longitudinal strain (GLS) via speckle tracking echocardiography can detect cardiac involvement in patients suffering from SLE. We decided to determine the echocardiographic features and subsequent early diagnosis of cardiac involvement in patients with SLE utilizing the GLS index via speckle tracking echocardiography.

Methods: In this cross-sectional study, we compared female patients with SLE of at least 2 years’ duration and healthy controls in terms of the left ventricular (LV) GLS via speckle tracking echocardiography. After data collection in both groups, the GLS index and the ejection fraction were evaluated.

Results: We analyzed and compared the LV echocardiographic parameters of 33 patients with SLE (mean age=25.45±0.63 years) with those of 35 healthy controls (mean age=27±0.45 years). The apical 2-chamber view indicated a significant decrease in the LV GLS in the case group by comparison with the healthy controls (P=0.005). The LV GLS in the apical 3-chamber view was significantly lower in the case group than in the control group (P=0.006). The LV GLS in the apical 4-chamber view revealed no significant difference between the case and healthy control groups (P=0.2). While there was a significant difference between the case and control groups visà- vis the LV GLS (P=0.02), the LV ejection fraction measured with the Simpson method showed no significant difference between the 2 groups (P=0.96).

Conclusion: GLS speckle tracking echocardiography is a noninvasive method with diagnostic and prognostic values; it may, therefore, be a sensitive marker for the diagnosis of myocarditis and other cardiac involvements in patients with SLE.

• Doppler Echocardiography
• Global Longitudinal Strain
• Left Ventricle
• Systemic Lupus Erythematosus

• CV events
• CV mortality
• Pulmonary hypertension (PH)
• chronic kidney disease (CKD)
• death, cardiovascular disease (CVD)
• dialysis
• end-stage kidney disease (ESKD)
• meta-analysis
• pulmonary artery pressure
• systematic review

• COPD
• end-stage renal disease
• parenchymal lung disease
• pulmonary hypertension

We describe a patient with severe pulmonary arterial hypertension scheduled to undergo live-related renal transplantation. We emphasise on meticulous anaesthetic management and early renal transplantation to prevent the progression of disease which would become refractory to treatment, leading to right ventricular failure. Regional (continuous epidural) anaesthesia has been used as technique of choice, where the selective advantages of this technique have been put to good use.

• Anaesthesia
• end-stage renal disease
• pulmonary arterial hypertension
• renal transplantation

• Arteriovenous fistula
• heart failure
• tricuspid chronic renal failure

Echocardiographic global longitudinal strain (GLS) is increasingly recognised as a more effective technique than conventional ejection fraction (EF) in detecting subtle changes in left ventricular (LV) function. This study investigated the prognostic value of GLS over EF in patients with advanced Chronic Kidney Disease (CKD).

The study included 183 patients (57% male, 63% on dialysis) with CKD stage 4, 5 and 5Dialysis (D). 112 (61%) of patients died in a follow up of 7.8 ± 4.4 years and 41% of deaths were due to cardiovascular (CV) disease. GLS was calculated using 2-dimensional speckle tracking and EF was measured using Simpson’s biplane method. Cox proportional hazard models were used to assess the association of measures of LV function and all- cause and CV mortality.

The mean GLS at baseline was -13.6 ± 4.3% and EF was 45 ± 11%. GLS was a significant predictor of all-cause [Hazard Ratio (HR) 1.09 95%; Confidence Interval (CI) 1.02–1.16; p = 0.01] and CV mortality (HR 1.16 95%; CI 1.04–1.30; p = 0.008) following adjustment for relevant clinical variables including LV mass index (LVMI) and EF. GLS also had greater predictive power for both all- cause and CV mortality compared to EF. Impaired GLS (>-16%) was associated with a 5.6-fold increased unadjusted risk of CV mortality in patients with preserved EF.

In this cohort of patients with advanced CKD, GLS is a more sensitive predictor of overall and CV mortality compared to EF. Studies of larger populations in CKD are required to confirm that GLS provides additive prognostic value in patients with preserved EF.

• Adult
• Aged
• Allografts
• Austria
• Cardiomegaly/complications
• Cardiomegaly/diagnostic imaging
• Cardiomegaly/mortality
• Cause of Death
• Chi-Square Distribution
• Female
• Graft Survival
• Heart Atria/diagnostic imaging
• Humans
• Kaplan-Meier Estimate
• Kidney Failure, Chronic/complications
• Kidney Failure, Chronic/diagnosis
• Kidney Failure, Chronic/mortality
• Kidney Failure, Chronic/surgery
• Kidney Transplantation/adverse effects
• Kidney Transplantation/mortality
• Life Expectancy
• Male
• Middle Aged
• Multivariate Analysis
• Patient Selection
• Predictive Value of Tests
• Proportional Hazards Models
• Registries
• Risk Factors
• Time Factors
• Treatment Outcome
• Ultrasonography

• Fibrosing mediastinitis
• Lymphangioleiomyomatosis
• Metabolic disorders
• Myeloproliferative disorders
• Pulmonary Langerhans cell histiocytosis
• Renal failure
• Sarcoidosis
• Splenectomy